Photographic/Observation Release Form

Photographic & Observation release

Please fill out the form below authorizing consent to be photographed. If you prefer to fill out your photo release on a physical form, we invite you to download the Photo/Observation Release Form, complete and fax it to us at (612) 706-5555. Please print completed documents for your personal records.

For questions, please contact us by calling (612) 789-1236 or email [email protected].

Our Mission is to promote the maximum development of the whole child and adult through innovative, individualized and comprehensive brain-centered programs and services.

Location & Contact Information

1800 NE 2nd Street, Minneapolis, MN 55418
(612) 789-1236 / [email protected]
Main Fax: (612) 706-5555
Fax for Home-Based Services: (612) 706-5509
Fax for Clinical Services: (612) 746-5144

Stay Informed
Sign-up for our newsletter and special offers!

Quick Links
Donate
Employment
Store
Terms of Use
Nondiscrimination Policy
Shipping & Returns
Privacy Policy

A Chance To Grow is a 501(c)(3) non-profit organization. Gifts are tax-deductible. ACTG does not discriminate on the basis of race, sex, religion, age, disability, sexual orientation, or marital status.
© 2023 A Chance To Grow, All rights reserved.